It isn't recommended for babies to have a pacifier until after 4 weeks old.
The American Academy of Pediatrics (AAP) recommends delay of the pacifier until breastfeeding is well established at approximately 4 weeks of life.
Some babies have no "nipple confusion" on day 1 and can take a paci without a problem then go right back onto the breast. The average newborn nurses 8-12 times per day, so there is not a whole lot of room for the paci before 4 weeks.
When the frequency of nursing slows down slightly and the time it takes to complete a feed gets shorter, you can introduce a pacifier. There is also a recommendation that young babies be offered the paci as they fall asleep as it may offer some additional protection against SIDS.
Reviewed by Dr. Sara Connolly, March 2020
I think we first tried to introduce a pacifier around 3 weeks, and she wouldn’t have any of it! I mean, I TRIED. Different shapes, brands, sizes, you name it. She wanted no part of it, but basically came out of the womb sucking her thumb. I think Kristen is right, I think it’s a choice on their part!
I waited about 3 weeks. We had no problem with nipple confusion. I tried to offer the paci only when my son was put down to sleep, because I didn’t want him to have a paci in his mouth 24/7. It worked out really well. He never wanted his paci when awake, and I think it helped him to fall asleep faster because the paci was only part of his sleeping routine.
We started a paci at 2 or 3 days old. We were still in the hospital. I couldn’t even go to the bathroom without my son screaming, so I popped it in. He didn’t have any issues with nipple confusion. He actually just weaned himself at 14.5 months old. We waited 8 weeks for a bottle, and that’s when we sometimes had issues with refusing the breast. I’m not sure I believe in “nipple confusion” exactly. I think it’s more of a decision on the baby’s part. I think sometimes they prefer one “nipple” over another. With the bottle, the flow was faster and immediate, so of course he preferred it. So (just my opinion) I think sometimes babies choose a paci or bottle over the breast.